Case report on chronic liver disease with portal hypertension with massive ascites

Portal hypertension is an increase in the blood pressure within the system of veins called the Hepatic portal venous system. Veins coming from the stomach, intestine, spleen, and pancreas merge into the portal vein, which then branches into smaller vessels and travels through the liver. If the vessels in the liver are blocked due to liver damage, blood cannot flow properly through the liver. As a result, high pressure in the portal system develops. This increased pressure in the portal vein may lead to the development of large, swollen veins (varices) within the esophagus, stomach, rectum, or umbilical area (belly button). Varices can rupture and bleed, resulting in potentially life-threatening complications. We present a case of portal hypertension with massive ascites- A 43-year-old female was admitted with chief complaints of abdominal distension, abdominal pain, and shortness of breath prior to 15 days of presentation and the symptoms were gradually progressive in nature. Her past medical history reveals she had similar complaints in the past and known cases of chronic liver disease. After admission, she has been diagnosed with portal hypertension along with Refractory ascites. The management included antihypertensives and human albumin, A high protein diet with salt and fluid restrictions, large-volume paracentesis procedure was carried out daily.

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A comparison of duplex Doppler sonography of the ligamentum teres and portal vein with endoscopic demonstration of gastroesophageal varices in patients with chronic liver disease or portal hypertension, or both

Journal of Ultrasound in Medicine ◽

10.7863/jum.1992.11.7.327 ◽

1992 ◽

Vol 11 (7) ◽

pp. 327-331 ◽

Cited By ~ 4

Author(s):

P R Gibson ◽

R N Gibson ◽

M R Ditchfield ◽

J D Donlan

Keyword(s):

Portal Hypertension ◽

Liver Disease ◽

Portal Vein ◽

Chronic Liver Disease ◽

Doppler Sonography ◽

Ligamentum Teres ◽

Chronic Liver ◽

Gastroesophageal Varices ◽

Duplex Doppler ◽

Duplex Doppler Sonography

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Duplex Doppler ultrasound of the ligamentum teres and portal vein: A clinically useful adjunct in the evaluation of patients with known or suspected chronic liver disease or portal hypertension

Journal of Gastroenterology and Hepatology ◽

10.1111/j.1440-1746.1991.tb01147.x ◽

1991 ◽

Vol 6 (1) ◽

pp. 61-65 ◽

Cited By ~ 8

Author(s):

PETER R. GIBSON ◽

ROBERT N. GIBSON ◽

JOHN D. DONLAN ◽

MICHAEL R. DITCHFIELD ◽

PRITHI S. BHATHAL

Keyword(s):

Portal Hypertension ◽

Liver Disease ◽

Portal Vein ◽

Chronic Liver Disease ◽

Doppler Ultrasound ◽

Ligamentum Teres ◽

Chronic Liver ◽

Duplex Doppler Ultrasound ◽

Duplex Doppler

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Limited diagnostic performance of controlled attenuation parameter for assessing hepatic steatosis in patients with advanced chronic liver disease and portal hypertension

10.1055/s-0038-1654646 ◽

2018 ◽

Author(s):

G Semmler ◽

J Stift ◽

B Scheiner ◽

R Paternostro ◽

P Schwabl ◽

...

Keyword(s):

Portal Hypertension ◽

Liver Disease ◽

Chronic Liver Disease ◽

Hepatic Steatosis ◽

Diagnostic Performance ◽

Chronic Liver ◽

Controlled Attenuation Parameter ◽

Attenuation Parameter

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Results of liver and spleen endoscopic ultrasonographic elastography predict portal hypertension secondary to chronic liver disease

Endoscopy International Open ◽

10.1055/a-1233-1934 ◽

2020 ◽

Vol 08 (11) ◽

pp. E1623-E1632

Author(s):

Carlos Robles-Medranda ◽

Roberto Oleas ◽

Miguel Puga-Tejada ◽

Manuel Valero ◽

Raquel Del Valle ◽

...

Keyword(s):

Liver Cirrhosis ◽

Portal Hypertension ◽

Liver Disease ◽

Chronic Liver Disease ◽

Predictive Value ◽

Strain Ratio ◽

Chronic Liver ◽

Spleen Stiffness ◽

Eus Elastography ◽

Sensitivity Specificity

Abstract Background and study aims Assessment of endoscopic ultrasonography (EUS)-elastography of the liver and spleen may identify patients with portal hypertension secondary to chronic liver disease. We aimed to evaluate use of EUS-elastography of the liver and spleen in identification of portal hypertension in patients with chronic liver disease. Patients and methods This was a single-center, diagnostic cohort study. Consecutive patients with liver cirrhosis and portal hypertension underwent EUS-elastography of the liver and spleen. Patients without a history of liver disease were enrolled as controls. The primary outcome was diagnostic yield of liver and spleen stiffness measurement via EUS-elastography in prediction of portal hypertension secondary to chronic liver cirrhosis. Cutoff values were defined through Youden’s index. Overall accuracy was calculated for parameters with an area under the receiver operating characteristic (AUROC) curve ≥ 80 %. Results Among the 61 patients included, 32 had cirrhosis of the liver. Liver and spleen stiffness was measured by the strain ratio and strain histogram, with sensitivity/(1 − specificity) AUROC values ≥ 80 %. For identification of patients with cirrhosis and portal hypertension, the liver strain ratio (SR) had a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 84.3 %, 82.8 %, 84.4 %, and 82.8 %, respectively; the liver strain histogram (SH) had values of 87.5 %, 69.0 %, 75.7 %, and 83.3 %, respectively. EUS elastography of the spleen via the SR reached a sensitivity, specificity, PPV, and NPV of 87.5 %, 69.0 %, 75.7 %, and 83.3 %, respectively, whereas the values of SH were 56.3 %, 89.7 %, 85.7 %, and 65.0 %, respectively. Conclusion Endoscopic ultrasonographic elastography of the liver and spleen is useful for diagnosis of portal hypertension in patients with cirrhosis.

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